{Reference Type}: Journal Article
{Title}: Usefulness of age-adjusted N-terminal prohormone of brain natriuretic peptide level as a diagnostic marker for incomplete Kawasaki disease in children.
{Author}: Rodríguez-González M;Castellano-Martínez A;Alonso-Ojembarrena A;
{Journal}: Emergencias
{Volume}: 31
{Issue}: 2
{Year}: Abr 2019
{Factor}: 5.345
{Abstract}: The main objective was to assess the diagnostic usefulness of age-adjusted level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as a diagnostic marker in children suspected of having incomplete Kawasaki disease (IKD). The secondary aim was to compare the diagnostic yield of NT-proBNP level with the yield of other markers currently recommended by the American Heart Association (AHA).
Descriptive cross-sectional study of a case series of patients under the age of 14 years admitted with clinical suspicion of IKD between 2013 and 2017. We analyzed NT-proBNP level adjusted for age. Demographic, clinical, echocardiographic, analytic, and microbiologic findings were gathered from computerized charts. Two independent evaluators made the diagnosis of IKD according to AHA criteria.
We included 70 cases, and 19 (27%) were diagnosed with IKD. Patients with IKD had higher NT-proBNP levels than patients with other febrile diseases, and the proportion of cases of elevated age-adjusted NT-proBNP level was also higher in the IKD group (84% vs 4%; P<.001). The diagnostic yield of age-adjusted NT-proBNP for IKD was good (area under the receiver operating characteristic curve, 0.90; 95% CI, 0.80-0.99) and significantly higher than the yields for C-reactive protein, erythrocyte sedimentation rate, albumin, and sterile pyuria (P<.001, all comparisons).
NT-proBNP level may prove to be a valid diagnostic marker for IKD, possibly offering a higher diagnostic yield than the analyses currently recommended for children suspected of having IKD.
Evaluar la validez diagnóstica del NT-proBNP ajustado por la edad para enfermedad de Kawasaki incompleta (EKI) en pacientes pediátricos con sospecha clínica de EKI y comparar su capacidad diagnóstica con los parámetros analíticos diagnósticos recomendados actualmente por la American Heart Association (AHA).
Se incluyó a todos los pacientes menores de 14 años ingresados por sospecha de EKI desde 2013 hasta 2017. Se registró el valor de NT-proBNP ajustado por la edad, datos demográficos, clínicos, analíticos, ecocardiográficos y microbiológicos. El diagnóstico de EKI lo realizaron dos evaluadores según los criterios de la AHA.
Se incluyeron 70 pacientes: 19 (27%) fueron clasificados como EKI, y presentaron mayores concentraciones de NT-proBNP (p < 0,001), y un mayor porcentaje de casos de NT-proBNP elevado para la edad (84% vs 4%; p < 0,001) en comparación con otras enfermedades febriles. El NT-proBNP ajustado por la edad tuvo una buena capacidad diagnóstica para la EKI (área bajo la curva = 0,90; IC95% 0,80-0,99), superior a la proteína C reactiva (p < 0,001), velocidad globular de sedimentación (p < 0,001), albúmina (p < 0,001) y piuria estéril (p < 0,001).
El NT-proBNP podría ser un test diagnóstico válido para la EKI y potencialmente superior a los parámetros analíticos actualmente recomendados en los pacientes pediátricos con sospecha de EKI.